Branbur Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

BRANBUR DIALYSIS LLC

Doing business as

Puddledock Dialysis

Practice address

4650 Puddledock Rd
Prince George, VA 23875-1235

Phone

(804) 957-5910

Fax

(804) 957-5916

NPI assigned

Apr 18, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Puddledock Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

DaVita Puddledock DialysisCCN 492511

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jul 7, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

17

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Renal Treatment Centers Mid Atlantic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandy M Gibson, MD

  • Nephrology Physician
  • Richmond, VA
  • NPI 1548220288
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Richard A Gayle, MD

  • Nephrology Physician
  • Richmond, VA
  • NPI 1033179395

  Dialysis facility

  Care Compare affiliation Name & address match
• Sandy M Gibson, MD

  • Nephrology Physician
  • Richmond, VA
  • NPI 1548220288

  Dialysis facility

  Care Compare affiliation Name & address match
• Ari Ben Hirsch, MD

  • Nephrology Physician
  • Richmond, VA
  • NPI 1396952594

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1043873664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 PUDDLEDOCK RD",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238751235",
            "telephone_number": "804-957-5910",
            "fax_number": "804-957-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANBUR DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043873664",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puddledock Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Puddledock Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Best Taxi LLC
• Alfreda Best, CSAC
• Martha Carter Bland
• Kadarnath Shammie Boodram, MD
• James William Bowles, M.D.
• Lesli Antoinette Brown, M.D.
• Melba Williams Bryant
• Michael J Bunda, M.D.
• Mallory Taylor Cain, PA
• Caldwell Pediatrics and Wellness Center

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Prince George, VA
• Providers in Prince George, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.